Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 21720 | FL |
NPI | 1144659053 |
---|---|
Provider Name | Viet Ho |
First Address | Winter Haven, FL 33880-4000 |
Second Address | Winter Haven, FL 33880-4000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2013 |
Last Update Date | 27/03/2020 |